Medical Billing Specialist in Columbus, OH

Columbus, OH area urgent care center in need of a Medical Billing Specialist. This position would be responsible for collecting, posting, and managing account payments. Responsibilities will also include charge entry, insurance denials, submitting claims, clearing house rejections, and following up with insurance companies.

Responsibilities and Duties

• Posts charges, insurance and patient payments.
• For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary insurer.
• Obtaining referrals and pre-authorizations as required for procedures.
• Reviewing patient bills for accuracy and completeness and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Following up on unpaid claims within standard billing cycle timeframe.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Calling insurance companies regarding any discrepancy in payments if necessary.
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts for insurance of patient follow-up.
• Researching and appealing denied claims.
• Answering patient or insurance telephone inquiries.
• Setting up patient payment plans and work collection accounts.
• Updating cash spreadsheets and running collection reports.
• In addition to these general duties, an individual employer may request that you perform. other duties that fit with your training and background experience or provide further training for new duties.
• Follows HIPAA guidelines in handling patient information.
• May periodically create insurance or patient aging reports using the medical practice reporting module. These reports are used to identify unpaid insurance claims or patient accounts.
• May have to verify patient benefits eligibility and coverage.
• Ability to look up ICD 10 diagnosis and CPT treatment codes from online service or using traditional coding references.
• Listens respectfully, gives feedback directly, honestly and talks with others to clarify differences.
• Utilizes appropriate services when needed to communicate with employees and patients with speech and hearing disorders.
• Demonstrates a willingness to look at new ideas and work in a changing environment.
• Understands, verbalizes and participates in the quality improvement process.
• Supports initiatives designed to improve individual and organizational performance.

Qualifications and Skills

• High school diploma or equivalent
• Two (2) years previous experience as a medical biller or in a related healthcare administrative position
• Knowledge of insurance guidelines including HMO/PPO, Medicare, Tricare, and other payers’ requirements and practice management systems
• Knowledge of medical billing/collection practices and basic coding
• Competent use of computer systems, software, and 10 key calculators
• Familiarity with CPT and ICD-10 Coding
• Effective communication abilities for phone contacts with insurance payers to resolve issues
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients
• Ability to work well in a team environment. Being able to manage priorities, delegate tasks if needed
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
• Knowledge of medical terminology and basic accounting and bookkeeping procedures
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
• Ability to multitask
• Good communication and language skills required
• Able to multitask, prioritize, and manage time efficiently
• Self-motivated and self-directed; able to work without supervision
• Excellent verbal and written communication skills
• Proficient computer skills, Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel); working knowledge of billing software a plus
• Strong customer service skills and comfortable answering both patient and insurance company questions
• Able to analyze problems and strategize for better solutions
• All employees must be able to provide proof of their identity and their right to work in the United States.